Attachment #5.pdf
PDF 290 KB Posted
- Attached to
- PSYCHOLOGICAL EVALUATION SERVICES
- Solicitation number
- 5400024264
- Issued by
- South Carolina
About this file
This is a Form 909B judicial instruction document from the South Carolina Department of Juvenile Justice (DJJ) under the direction of Executive Director Freddie B. Pough, designed for use in General Sessions Court waiver evaluations involving juveniles whose cases are subject to State v. Hitopoulus protections. The form is completed by the County Case Manager prior to conducting interviews with juveniles to determine whether their cases should be transferred to adult court. The document outlines the purpose of the psychological evaluation ordered by the Family Court and informs juveniles of the confidentiality protections afforded to any oral or written communications made to the psychologist regarding their charges, with limited exceptions for waiver hearing proceedings.
The form serves as an informed consent instrument requiring the juvenile's acknowledgment that they understand the evaluation process, the scope of confidentiality protections, and their voluntary participation. It includes signature lines for the juvenile, parent or guardian, attorney, and witnesses, along with fields for recording the juvenile's full name, date of birth, evaluation date and time, and witness information. This document is part of a broader procurement for Psychological Evaluation Services by the State of South Carolina and establishes the procedural framework and legal protections governing juvenile waiver evaluations within the state's court system.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment #3.pdf | ||
| Solicitation.pdf | ||
| Attachment #2.pdf | ||
| Attachment #1.pdf | ||
| Attachment #4.doc | DOC document | |
| No Award.docx | DOCX document |
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Text version
Form 909B 09-2020
P.O. Box 21069 Columbia, SC 29221-1069 djj.sc.gov
Freddie B. Pough Executive Director Governor
Henry McMaster
Understanding of Family Court Hitopoulus Order for the General Sessions Court Waiver Evaluation
INSTRUCTIONS: This form is to be completed by the County Case Manager prior to conducting an interview with a juvenile regarding Evaluation for General Sessions Court Waiver when the juvenile’s court order includes the protections of State v. Hitopoulus, 359 S.E.2d 747 (1983).
Juvenile Full Name: Date of Birth:
Date: Time:
Witness Name Title:
This evaluation has been ordered by the Court for the purposes of assisting the Court in determining whether your case should be transferred to the Court of General Sessions (Adult Court), and whether for the purposes of criminal prosecution you should be treated as an adult. The Family Court has issued an Order in your case protecting the use of any oral or written communication that you have with the psychologist related to your charges, in conjunction with this evaluation, as evidence against you in any court proceeding other than the Waiver hearing.
I HAVE READ, OR HAD READ TO ME, THIS STATEMENT AND I UNDERSTAND THAT ANY
STATEMENT I MAKE TO THE PSYCHOLOGIST CONCERNING MY CHARGES CANNOT BE
USED AGAINST ME IN ANY COURT HEARING, OTHER THAN THE WAIVER HEARING.
I am willing to participate in this evaluation and answer the questions presented to me. I do not wish to talk to my lawyer at this time. I understand and know what I am doing. No promises, threats, or inducements have been made to me and no pressure or coercion of any kind has been used against me.
Juvenile’s Signature:
Parent/Guardian’s Signature:
Attorney’s Signature:
Witnesses’ Signature:
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